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31 July 2012

Multiple births policy: the final (Year 4) maximum multiple birth rate

As set out in Chief Executive’s letter CE(12)01, the Authority has decided to set the final (Year 4) maximum multiple birth rate at 10%, the rate we have been aiming for from the outset of the policy.

This means no more than 10% of a centre’s annual birth events, from treatment started on or after 1 October 2012, should be multiple births. Births from IVF, ICSI and GIFT treatments using fresh and frozen embryos/eggs, from patients’ own eggs and donor eggs are included in this multiple birth rate. Births from IUI or DI are excluded.

The Multiple Births General Directions 0003, attached to this letter, have been revised to reflect the new target and will come into effect on 1 October 2012.

 

Ongoing monitoring

Your multiple births minimisation strategy is critically important, as are your arrangements for reviewing and auditing the strategy. At inspection we look at evidence that your strategy and outcomes are reviewed in light of your performance with regard to the target.

Compliance with this new target is monitored on an on-going basis. We monitor multiple pregnancy rates using the latest performance information available through the Risk Based Assessment Tool. Where analysis of clinical multiple pregnancy rates indicates that the resulting multiple live birth rate is likely to be in excess of the target at a statistically significant level, you will be alerted to this so that you can review your multiple births minimisation strategy. A clinical multiple pregnancy rate of 13% is considered likely to result in a multiple live birth rate of 10%. 

Since February it has been possible for you to access an analysis of your own outcomes, including multiple clinical pregnancy rates, from the Risk Based Assessment Tool through the Clinic Portal. The PR of a licensed centre will now receive an email from us if our monitoring indicates performance that may require review and /or improvement.
 
Where we have concerns that a licensed centre is likely to be non-compliant with requirements, our contact with the centre will be in line with the HFEA Compliance and Enforcement Policy. 

 

Sharing best practice

We will continue to work closely with the professional bodies and the wider sector to review and share best practice around minimising multiple births.

We will continue to make information available to centres through the One at a Time website and through future reviews of professional body guidance. We held four regional workshops for centre staff in February and March 2012 and attendees appreciated the opportunity to learn from other clinics’ experiences, to discuss how to communicate information to patients and to hear about longer term paediatric outcomes.

If you have any further questions about the content of this letter, please contact your Inspector.

Yours sincerely,

Professor Lisa Jardine CBE,
Chair

Page last updated: 17 August 2012

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